title: Six-year trend analysis of nosocomial candidemia and risk factors in two intensive care hospitals in Mato Grosso, midwest region of Brazil.
abstract: We conducted this cross-sectional retrospective study using clinical and laboratory data from two tertiary hospitals in Cuiabá, Mato Grosso, Brazil, in order to explore the risk factors and estimate mortality, prevalence and lethality of candidemia between 2006 and 2011. A total of 130 episodes of candidemia were identified. The prevalence of candidemia was 1.8 per 1,000 admissions, the mortality rate was 0.9 per 1,000 admissions, and the lethality was 49.2 %. The main agent in this population was Candida parapsilosis (n = 50), followed by C. albicans (n = 45). Comparison between the numbers of episodes in the two triennia revealed that the non-albicans group grew by 48.2 %. The distribution of yeast species of Candida per hospital unit revealed that C. albicans was more prevalent than C. parapsilosis in the adult ICU and C. parapsilosis was more prevalent than C. albicans in the neonatal ICU. Patients remained hospitalized for an average of 53.5 days. Central venous catheters, parenteral nutrition and age were the variables that proved to be independent in the multivariate analysis and that maintained a statistically significant association with the incidence of death in patients with candidemia. The annual prevalence of candidemia showed a significant increase in the second triennium (2009-2011) compared with the first (2006-2008) probably due to increased exposure to risk factors: central venous catheter, H2 blockers, nutrition parenteral corticosteroids and mean hospital duration.
authors.affiliation: Laboratório de Micologia, Faculdade de Medicina, Universidade Federal de Mato Grosso, Av. Fernando Correa da Costa, No. 2367, bairro Boa Esperança, Cuiabá, MT, CEP 78060-900, Brazil.
authors.forename: Hugo Dias
authors.initials: HD
authors.lastname: Hoffmann-Santos
authors.forename: Claudete Rodrigues
authors.initials: CR
authors.lastname: Paula
authors.forename: Ana Caroline Akeme
authors.initials: AC
authors.lastname: Yamamoto
authors.forename: Tomoko
authors.initials: T
authors.lastname: Tadano
authors.forename: Rosane C
authors.initials: RC
authors.lastname: Hahn
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001938:Brazil / Q000453:epidemiology; D002175:Candida / Q000145:classification / Q000302:isolation & purification*; D058387:Candidemia / Q000453:epidemiology* / Q000382:microbiology* / Q000401:mortality; D002648:Child; D002675:Child, Preschool; D003428:Cross Infection / Q000453:epidemiology* / Q000382:microbiology*; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007362:Intensive Care Units; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D012189:Retrospective Studies; D012307:Risk Factors; D016019:Survival Analysis; D062606:Tertiary Care Centers; D055815:Young Adult